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Outcome of clinical risk management in the Gloucester rehabilitation service

Wotton Lawn, Horton Road, Gloucester GL1 3WL

Faith Cornelius, Trainee Clinical Psychologist

University of Exeter

Daphne Kilpatrick, Community Psychiatric Nurse

ACT, 136 Stroud Road, Gloucester

Kate Blazey, Senior House Officer in Psychiatry

Wotton Lawn, Horton Road, Gloucester

Declaration of interest

None.

AIMS AND METHOD

To assess the impact of a clinical risk assessment and management policy introduced in a tertiary rehabilitation service, in response to UK government statute. The study assessed the effect of a formal risk management approach for high-risk cases over a year, in terms of changes in risk-associated behaviour and perceived levels of risk, and in achievement of clinical risk management goals.

RESULTS

Initially 35 of 107 patients were rated as high risk, mostly of neglect or of harm to others, and were subjected to formal risk management. At follow-up only 16 patients were still rated as high risk, most reduction occurring in risk of neglect. Half of the 112 risk management goals established were fully achieved, 58 partially and 18 not achieved. Total Social Behaviour Schedule ratings were significantly lower at follow-up.

CLINICAL IMPLICATIONS

Risk management appeared to be successful in terms of reducing overall levels of risk, the achievement of risk management goals and the reduction of risk-associated behaviours. The lack of a control group and blindness limits the validity of these findings. However, organised risk management procedures may help to support and promote good general clinical management.

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